Published 12:00 am, Tuesday, August 20, 2013

Major changes are underway at the state Medical Examining Board, in an attempt to reduce long delays in disciplining doctors.

The state legislature recently expanded the board from 15 to 21 members to be able to hold hearings more quickly when complaints are filed against doctors. Two board members are now involved earlier in investigations, and physicians now must respond to investigations earlier in the process, said William Gerrish, spokesman for the state Department of Public Health (DPH).

Also, the DPH plans to hire a consultant by the fall to conduct a full review of the way complaints against doctors are investigated and adjudicated, Gerrish said.

Most visibly, Gov. Dannel P. Malloy has also installed a new chairperson on the board, replacing Anne C. Doremus, a Manchester Republican, with Kathryn Emmett, a prominent Democrat and lawyer in Stamford who worked on Malloy's transition team in 2010. Emmett said she wants to improve the board's operations.

"I am concerned about having the medical examining board function well and improve in some areas that affect its efficiency and public perception,'' Emmett said. "Certainly, I don't think the speed of our process is an overriding concern, but a lack of speed is worrisome."

A review of disciplinary actions in June by the Conn. Health I-Team showed that the medical board rarely acts within a year of an incident occurring - and sometimes the process takes as long as four years, with physicians still practicing freely during that time.

A report prepared by Dr. Eric Hodgson for DPH Commissioner Jewel Mullen in October 2011 was blunt in its assessment of doctor discipline in Connecticut.

"Legislators and members of the public have expressed concerns that the [medical board] is a biased haven of physicians protecting physicians,'' Hodgson wrote, adding, "the DPH-driven investigation process is too slow and outdated, and [the] lack of [board] involvement leads to incomplete investigations."

One board member, Dr. Henry Jacobs, a West Hartford obstetrician and gynecologist, said that changing the chairperson and adding more members would not improve efficiency. He said that would only happen if the board was independent.

"I am in favor of a truly independent medical examining board,'' he said. "The board is totally dependent on DPH's staff, and that's really the bottleneck."

Connecticut is one of a few states that does not have an independent medical examining board, with its own staff of investigators and lawyers. Instead, Connecticut's board is staffed by DPH employees, whom many say are stretched thin overseeing myriad health professionals and institutions.

Emmett said some of the delays in disciplining doctors are due to the fact that board members are all volunteers with busy lives, making it hard to schedule hearings. She said having more members should help.

But she acknowledged that the structure of the board, which lacks its own budget and staff, is problematic. The panel relies on DPH staff to investigate complaints about doctors.

"The process does take time, but having no budget whatsoever makes it much harder,'' she said. "Everyone is working together to make changes, but we have some basic burdens and hurdles to overcome."

Jacobs said the DPH process is lengthy - from finding time to investigate complaints and bring in medical experts to review cases, to scheduling hearings and writing memorandums of decision for the board to consider for disciplinary action.

"The lawyers for DPH generally do a good job, but they are pretty slow,'' Jacobs said.

He and some other board members also believe a doctor should lead the board because an understanding of the practice of medicine is vital.

"Anne did a good job, but it is time for a physician to lead the board,'' he said.

In 2012, Public Citizen, a consumer advocacy group, ranked Connecticut fifth-lowest among states in taking serious disciplinary actions against physicians between 2009 and 2011.

The medical board has improved its operations under Doremus and with DPH's support, said Emmett, a former Superior Court judge who was appointed to the board as a member last fall. She said DPH and the board are implementing many of the recommendations made by Hodgson in his 2011 report.

Hodgson wrote that "finger-pointing" between board members and DPH has eroded public trust in the physician disciplinary process.

He concluded there were "tremendous time delays" in the investigation, adjudication and disciplinary process. The delays came in identifying consultants to review complaints, within the DPH legal office and between the time a compliance conference is held and the actual issuing of charges, Hodgson wrote.

Gerrish said the report was valuable, but that it is part of a larger effort by DPH and the board to improve its operations. DPH plans to hire a consultant by the fall to conduct a full review of the way complaints against doctors are investigated and adjudicated, he said.

Because some delays were caused by a lack of consultants, DPH is now offering incentives to doctors to serve, and is recruiting them through several medical societies, Gerrish said.

Legislation has increased the number of public board members from five to seven. Also, the board must have at least three doctors in specialty areas and a physician's assistant as members.

"Recent appointments [to the medical board] have been more patient-focused,'' David Bednarz, a spokesman for Malloy, said in an e-mail. "With all this in mind, we anticipate a reshaping of the culture of the board, as well."

Bednarz added that Doremus is remaining on the board to help Emmett with the transition and in implementing many of Hodgson's recommendations.

Doctors who have been disciplined by the board have criticized its operation. Dr. Richard Ochrym of Salisbury said he accepted a consent order and $2,000 fine in July for mishandling drugs, just to put an end to his dealings with DPH and the medical board. He said the process left no room for discretion in his case, which a DPH attorney said showed no improper care of patients.

"On a technicality, I'm guilty,'' said Ochrym, whose entire practice involves house calls. "But I was treated the same as a doctor who was selling pills on the streets.''

This story was reported under a partnership with the Connecticut Health I-Team (www.c-hit.org).